An integrated program of studies has been developed jointly by the Division of Urology and the Immunobiology Group at UCLA. Bladder cancer antigens that may be tumor (or tissue) specific are being sought using heterologous antisera and human antibodies generated in regional lymph nodes. Combination isotopic and PAGE electrophoretic and new immune techniques are being explored for antigen isolation and identification. Alterations in patient defense mechanisms involving lymphoid cells and macrophages will be assessed for prognostic value. Effects of bladder cancer and conventional therapy and especially immunotherapies on T and non-T lymphoid cell subsets and their proliferative and cytotoxic capabilities will be assessed. Alterations in macrophages as positive and/or negative contributors to these reactions as well as in monocyte chemotactic and cytotoxic capacities will be sought. The difficulties in assessing complex mixtures such as peripheral blood leukocytes are recognized, thus purification before testing is planned. Careful clinical evaluation including DNCB skin tests and serial follow up will permit correlation of clinical and laboratory findings, with particular attention to the effects of immune adjuvants. Improvement in the treatment of patients with bladder cancer will be sought by use of the immune adjuvants, C. parvum and Levamisole, and other agents to stimulate the immune system generally and selectively. Programs for patients with minimal disease are different from those with advanced disease. Optimal combinations of therapy (conventional and immunologic) will be investigated through sequential evaluation of immune and tumor parameters during therapeutic protocols. Tumor antigen preparations will be tested for ability to elicit positive specific delayed hypersensitivity. Bladder tumor antigen preparations will be considered for immunopharmacology and immunotherapy trials in conjunction with adjuvants.